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,9. Insurance Coverage - The jointly used dock is insured by one of the following: <br />property owner's homeowner's policy. <br />separate group/nrsocintfon owned policy. <br />list the following information: <br />name of insured <br />v <br />name of insurance carrier <br />name of insurance agency . D l 33--Zgn) <br />policy no. Oct as effective date of coverage `O 71 g7 <br />amount of coverage; Public liability, per person, per occurence $ 1, ONd&Q <br />Public liability, per occurence $ 11060, 0ilrj <br />10• Security and colicing of the Jointly used dock and property is provided by - <br />(check applicable items): <br />fencing. _& security lighting. X property owner's presence. <br />contract security service. other (specify) <br />DOCr INFORMATION <br />11• List Dock Use Area Specifications: t <br />A ex. 3 O � <br />Width of sm.:reline; ? pO f"t. Length of main dock from shore; fOG' ft. <br />Dock setbacks from side y , DO ft. and ft. <br />pmper-t lines at shore <br />12. Dock Constriction (check alplicable items): <br />seasonal doc: (relocated or replaced each year;. <br />permanent ni l ine wl tr. senscnal ieck. 1-1-1 per•:nanent piling and deckin <br />wooden decking. metal deckirg. <br />13 List Dock Accessories: <br />Number of fire extinguishers available at the dock a <br />Number of ii_`'e preservers available at the dock �- <br />14• Liat member of stirs in Aecli categgry ("alias" includes boat :Lifts): <br />Transient (day use only) sF'i4 !u Transient(dey use) off -shore buoys <br />ul+"� 4 <br />Permanent moorage slips _sn4 14L I•erwanent moorrige off -shore buoys <br />dry storage �rAck) 6111s Maximum number of boats at the dock <br />15• List number of off-street Narwing space; r,vaiiable for users of the joint use <br />dock. Parking, !f provided must not be separated from the dock by any public <br />road. N /q spaces. <br />